TY  - BOOK
AU  - Foley, Carroll
AU  - Gholami, Sherry
AU  - Groninger, Hunter
AU  - Najjar, Samer S
AU  - Rao, Anirudh
AU  - Sheikh, Farooq H
AU  - Singh, Manavotam
TI  - Benefits and Harms of Continuous Intravenous Inotropic Support as Palliative Therapy: A Single-Institution, Retrospective Analysis
SN  - 1049-9091
PY  - 2024///
KW  - *Heart Failure
KW  - *Palliative Care
KW  - Cardiotonic Agents/tu [Therapeutic Use]
KW  - Female
KW  - Heart Failure/dt [Drug Therapy]
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Prospective Studies
KW  - Retrospective Studies
KW  - United States
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Washington Hospital Center
KW  - Cardiovascular Disease Fellowship
KW  - Internal Medicine Residency
KW  - Medicine/Palliative Care
KW  - MedStar Georgetown University Hospital/MedStar Washington Hospital Center
KW  - Social Work
KW  - Journal Article
N2  - Use of continuous intravenous inotropic support (CIIS) strictly as palliative therapy for patients with ACC/AHA Stage D (end-stage) Heart Failure (HF) has increased significantly. The harms of CIIS therapy may detract from its benefits. To describe benefits (improvement in NYHA functional class) and harms (infection, hospitalization, days-spent-in-hospital) of CIIS as palliative therapy. Methods: Retrospective analysis of patients with end-stage HF initiated on CIIS as palliative therapy at an urban, academic center in the United States between 2014-2016. Clinical outcomes were extracted, and data were analyzed using descriptive statistics. Seventy-five patients, 72% male, 69% African American/Black, with a mean age 64.5 years (SD = 14.5) met study criteria. Mean duration of CIIS was 6.5 months (SD = 7.7). Most patients (69.3%) experienced improvement in NYHA functional class from class IV to class III. Sixty-seven patients (89.3%) were hospitalized during their time on CIIS, with a mean of 2.7 hospitalizations per patient (SD = 3.3). One-third of patients (n = 25) required at least one intensive care unit (ICU) admission while on CIIS therapy. Eleven patients (14.7%) experienced catheter-related blood stream infection. Patients spent an average of 20.6% (SD = 22.8), approximately 40 days, of their time on CIIS admitted to the study institution. Patients on CIIS as palliative therapy report improvement in functional class, survive 6.5 months following initiation, but spend a significant number of days in the hospital. Prospective studies quantifying the symptomatic benefit and the direct and indirect harms of CIIS as palliative therapy are warranted
UR  - https://dx.doi.org/10.1177/10499091231160162
ER  -